There is a need to be able to quantify tissue perfusion for the purpose of assessing the viability of ischemic tissue such as wounds and flaps. For wound care in diabetes, early detection of angiogenesis compromise is an important determinant of salvage. This reduces cost, reduces risk of amputation, and increases patient satisfaction. Approximately 10% of all flaps require revision with a salvage rate of approximately 85%. Effective monitoring flaps would provide early warning of possible complications for flap surgery and allow earlier intervention. Currently subjective visual observation is still commonly used to identify the improvement and assessment of grafts and wounds. An imager based on the spatial analysis of laser speckle will be developed as a standalone unit. This method employs spatial averaging of the dynamic events to obtain a global picture of the velocity image from one exposure. Images obtained from the same scene at different exposures can be used to improve accuracy of the velocity values. It allows acquisition of full-field perfusion images in real time. The short exposure time reduces the effects of motion artifacts. W with an increasingly high percentage of obesity in the U.S. population, more diabetic cases have emerged. The proposed laser speckle imager provides real-time noninvasive monitoring of tissue viability in patients undergoing hyperbaric oxygen therapy and/or surgery. It can reduce the financial costs and physical demands on the medical staff associated with the revision of skin grafts and by determining the effectiveness of continued HBO treatment. Its commercial marketability and application will become more apparent after the clinical trial. The scientific, technical, and clinical knowledge gained from this project can be utilized to improve protocols for hyperbaric oxygen therapy, reducing both costs and time of treatment. According to the Centers for Disease Control and Prevention, a total of 20.8 million people or 7% of the U.S. population have diabetes. The estimated diabetes cost in the U.S. in 2002 was $132 billion, about 11% of the total health care expenditure. This project is designed to develop an advanced, noncontact, and noninvasive optical imager to provide real-time, quantitative measurements of blood velocities in the selected wound areas of diabetic patients.